The Effectiveness of a New Smartphone App Using Personalized Health-Related Visual Imagery in Improving Adherence to Antiretroviral Therapy
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Abstract
Background: Mobile technologies have potential to deliver adherence promoting interventions which are cost-effective and scalable. However, existing mobile adherence interventions generally employ automated SMS reminders and have limited long-term efficacy as they focus on the forgetfulness aspect of medication non-adherence, and do not address the cognitive determinants of non-adherent behaviour. This study aimed to investigate the effectiveness of a smartphone app that links personal adherence to real-time simulated visual displays of viral activity on adherence to antiretroviral therapy (ART), illness perceptions, and medication beliefs. These features were intended to modify participants’ conceptualisations of their HIV infection and ART regimen to be more conducive to optimal adherence.
Methods: 28 people on ART were randomised to use either a standard or augmented version of the smartphone app. The augmented version contained additional components which illustrated to the participant, in real-time, the estimated concentrations of antiretroviral agents in blood plasma as well as personalized immune activity. Adherence to ART was assessed at baseline and three month follow-up using HIV viral load, pharmacy dispensing and self-report. Information was also collected on illness perceptions and medication beliefs.
Results: Participants who received the augmented application displayed a significantly higher level of self-reported adherence to ART at follow-up, compared to individuals who received the standard version (p = .02). Further, there was a significant decrease from baseline to three month follow-up in the proportion of participants classified as non-adherent in the augmented group p = .03). Greater usage of the app was associated with improvements understanding of HIV infection and perceived necessity for ART.
Conclusion: This research suggests that a smartphone app, using personalised health-related imagery and real-time feedback, is effective in facilitating adherence to ART. Study findings indicate that such an intervention may have considerable utility in the clinical care of people with HIV infection.
Methods: 28 people on ART were randomised to use either a standard or augmented version of the smartphone app. The augmented version contained additional components which illustrated to the participant, in real-time, the estimated concentrations of antiretroviral agents in blood plasma as well as personalized immune activity. Adherence to ART was assessed at baseline and three month follow-up using HIV viral load, pharmacy dispensing and self-report. Information was also collected on illness perceptions and medication beliefs.
Results: Participants who received the augmented application displayed a significantly higher level of self-reported adherence to ART at follow-up, compared to individuals who received the standard version (p = .02). Further, there was a significant decrease from baseline to three month follow-up in the proportion of participants classified as non-adherent in the augmented group p = .03). Greater usage of the app was associated with improvements understanding of HIV infection and perceived necessity for ART.
Conclusion: This research suggests that a smartphone app, using personalised health-related imagery and real-time feedback, is effective in facilitating adherence to ART. Study findings indicate that such an intervention may have considerable utility in the clinical care of people with HIV infection.
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